Inspection on 28/11/08 for Waterfield Supported Homes Ltd

This inspection was carried out on 28th November 2008.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Waterfield Supported Homes Ltd 15/06/06

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Waterfield Supported Homes Ltd 10 Dowanhill Road Catford London SE6 1HJ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mary Magee     Date: 2 8 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Waterfield Supported Homes Ltd 10 Dowanhill Road Catford London SE6 1HJ 02086976969 02086976969 coezeilo@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Waterfield Supported Homes Ltd care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Waterfield is a residential service for four adults with mental health problems. It is part of Waterfield Supported Homes Ltd. The home is situated in a Victorian house in a residential area, close to local shops, a post office and GP surgery. The home has a communal sitting room and dining area on the ground floor and well as a kitchen and a utility room, with a shower room and WC leading from this. There is also a conservatory overlooking a mature garden. There is space for off street parking at the front of the house. 4 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We made an unannounced visit to the home to do this key inspection. Prior to the visit we received from the service a completed AQAA. This was well detailed and contained all the information we requested. We met with all three residents in the home over refreshments. They had the opportunity to tell us individually and in a group what it is like to live at Waterfield Supported Homes. We spent time with the registered manager and the two support workers on duty. We received all the documentation and files in relation to staff and people using the services. We used case tracking to evaluate the outcomes of the care and support delivered. After the inspection we spoke to professionals from the community mental health Care Homes for Adults (18-65 years) Page 5 of 27 team, including care coordinators and a community psychiatric nurse. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has procedures in place to enable people test drive the service first. People know that the home they choose will meet their needs. The home does not offer a place to someone whose needs they cannot meet. No resident is admitted to the home unless a full needs assessment and risk assesment is undertaken first. The home provides an excellent service and successfully supports residents to develop independent living skills. Evidence: We found that before a person moves into the home they receive a good deal of information on the service available. Full needs assessments and risk assessments are undertaken before a placement is offered. Information is sought from health professionals in the mental health team to inform pre admission assessments. A transition period with overnight stays takes place before admission. It allows individuals to test drive the service and become acquainted with other residents. Residents told us of a new resident that is due to move in shortly. They look forward to him moving in permanently, the residents find that he mixes well and feels compatable Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: with the group. He has spent short periods with them in recent weeks. The home employs appropriate numbers of skilled staff to support residents. The service has a qualified mental health nurse on duty seven days a week. Since the home opened in 2005 all the residents after planned periods have successfully developed the skills necessary to move to more independent living settings. Residents have contracts supplied that they sign. Copies of these are held in by each resident in their own bedroom. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care and support arrangements are excellent. Residents benefit from the support and help they need from a skilled staff team. Staff are focused on helping to achieve the best outcomes for each individual that uses the service. Any risks are identified and managed appropriately. Evidence: Each resident as an assessment done of need, a written record is then made of support arrangements. We examined two care plans, we found that support plans are personalised and tailored according to each individuals need. Risk too is assessed prior to admission according to health and social services protocols, information on personal history is used to inform the risk management process. The risks are identified and recorded with care plans. Care coordinators find that the service is able to support appropriately people with high care needs, it is continually demonstrating this. A community psychiatric nurse that regularly visits residents spoke of the success achieved by the home, she said we have placed individuals at this home with some Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: complex needs, a number of homes would not be capable of meeting these needs appropriately, but Waterield support unit is successful in achieving this. Both care plans and risk assessments are kept under review. CPA meetings are held every six months. Good record keeping is taking place. Daily records of each individuals progress and welfare are recorded in detail, these are used to confirm the support given and the progress that takes place. Staff are vigilant in monitoring well being and are prompt in responding to any changes that individuals experience. We find that staff at the home support residents appropriately, they are alert to individuals welfare and are excellent communicators, they keep us fully informed on residents well being was the view of a care coordinator. Another community psychiatric nurse told us of the work done by the home staff, she said the presence of qualified mental health nurses benefits the residents, they work systematically through each area of need presented by the resident and produce detailed documentation which contributes greatly to working as a team. We found that residents present at last inspection in 2006 have all progressed well at the home and moved successfully to independent living. Community mental health professionals recognize that the manager and staff work closely with them focusing on achieving the best outcomes. As a result of the one to one and the expertise of staff the outcome for residents at this home is good. Residents take part in activities in the home and feel free to use facilities. We heard from residents how they enjoy the homely environment and the pleasure it gives as non institutionalized setting. We found that on arrival at the home a resident welcomed us and offered hot drinks from the kitchen. Residents hold regular meetings to discuss menus, outings and holidays. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home provides an excellent environment for people to lead meaningful lives. Residents are able to take part in age and peer appropriate activities. The opportunities given encourage and support community links and social inclusion for people living in the home. The style of living offers structure in peoples lives and accetance of responsibilities for household chores. Evidence: We met with all three residents. They tell us that this home is a good place to live. Individuals are supported to take part in age and peer appropriate, attend events and enjoy leisure pursuits both in the home and in the community. According to records seen relationships with family members and friends are encouraged and supported. The manager told us of ways they work together with family members to enable them compliment each others work. The CPN told us of the Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: progress made by the people using the service. She finds that the home is innoviative in introducing structure in peoples lives and this has contributed to enabling the residents achieve a balanced mental state. We observe that staff interact well with residents, they have developed effective working relationships. The home is generously staffed. Staff spend time with individuals providing much one to one support which reasures individuals. We heard of a resident that prefers transport in the managers car rather than use public transport. She appreciates that when possible the manager makes time to provide this so that she can attend events of her choice. The views of the care coordinators confirmed the individualised attention people receive. The home is working closely with the local community team to explore further opportunities in the community. Residents take responsibility for some houshold chores, People living at the home are offered a balanced diet. Nutritional needs are monitored on an ongoing basis, and special diets are catered for. We saw evidence of how a resident with diabetes is supported to manage her diabetes with a suitable diet. Residents are consulted on menu planning, meals are planned flexibly. We observed that a resident was absent for lunch, had a late lunch of fish freshly prepared for him when he returned back in the afternoon. Residents say they enjoy meals at the home, they tell us they eat out frequently an enjoy this as asocial occasion. Residents are very much part of the community, they frequent local community facilities. The spiritual needs of individuals are considered, two residents are supported to attend Sunday worship. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Those using the service receive good quality physical and mental health care and know that their needs will be met. Prescribed medication is administered at recommended times and appropriate support and encouragement is given to achieve compliance with medication. All care needs are assessed, appropriate arrangements are in place to respond appropriately to individuals need and provide the necessary support and encouragement. Progress and well being is monitored closely, any concerns are recognised early on and responded to appropriately, thus preventing crisis or relapses. Evidence: Personal support is delivered in accordance with individual wishes and their need, we observed how this is done in private. The service acknowledges the improvement achieved with residents in promoting personal care for individuals. All three residents previously accomodated in the first eighteen months of operation are now living independently in the community. The service was selected to participate in managing the revolving door syndrome that mental health clients exerience. This was as a result of the success achieved by people using this service. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: We observed the progress made by residents with promoting personal hygiene, some were identified as at risk of self neglect on admission. However with the right encouragement major obstacles have been overcome. Comments received from CPN visiting the home regularly confirmed the success achieved in this area and the competency of the staff team in addressing ny additional needs thst arise. Staff are sensitive and know from experience how to manage challenging stuations, we observed directly this when we visited. The mental and physical healthcare needs of residents are considered in needs assessments, plans are then drawn up and agreed on how to meet these. Staff deliver appropriate care and support to residents, which they value, it also inspires individuals capacity to attend to their appearance. We found that residents have regular health checks, consult with care coordinators and attend CPA meetings. Other areas where support is given include sight and hearing appointments, well woman and well men check ups. Record keeping is excellent, records demonstrate that healthcare is monitored and that prompt action is taken to address any concerns. We found that areas where more support and equipment is need that this is afforded. A resident is currently receiving support to quit smoking, the mental health team is delighted with the support given by staff at the home to this resident. Each resident has a medication profile in place, this is held with care and support plans. All residents are currently receiving prescribed medication, none of them are assessed as suitable to self administer. To record that this medicine is administered appropriately medication administration sheets are completed for each resident. All three MAR sheets in use were examined, signatures were present on each one. Medication was found to be accurate. records are held of all medicines received into the home, a record is also held of medicines returned to the pharmacist. It is recommended that the pharmacist receiving unwanted medication stamps the record book to acknowledge returned unwanted medication. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home welcomes the views of residents and treat any suggestions or ideas as a way to improve services. Residents have confidence in the complaints procedure. In place are policies and procedures that protect vulnerable adults from abuse or neglect. Evidence: Residents at the home feel safe and well supported. All staff working at the service know the importance of taking the views of residents seriously, and of listening to and responding to issues raised. We find that this home invites residents to participate in handovers, this enables staff to understand their needs better and inform the care planning process. Satisfaction questionaires are provided to residents on a rolling basis. The manager feels this helps empower residents to raise minor issue in addition to using the complaints procedure. Residents are given copies of the complaints procedure which they have in their bedrooms. We observed the ease at which residents raised issues with staff during the inspection, they tell us too that they feel their views are welcomed. The home has policies and procedures in place that safeguard vulnerable adults. All staff receive suitable training on this. Staff have a good awareness of the vulnerability of the client group to self neglect and exploitation. Residents have the opportunity to raise any worries or concerns on service satisfaction questionaires without any fears. The home benefits from th attendance of a volunteer that provides spiritual and Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: practical support to residents. Recruitment procedures are good with only staff that are fully vetted emloyed at the home. Residents receive information regarding independent advocacy to manage issues of concern as they deem appropriate, such as PALS (Patients Advocacy and Liaison Services). Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a well maintained homely and attractive premises, which helps the morale of residents. It is comfortable and provides good quality accommodation that people with enduring mental health problems find contributes to successful rehabilitation. Evidence: The home is a double fronted Victorian family house, in a residential area, near local shops. There is a communal sitting room with a dining area in the front of the house. There is a conservatory at the back, used as an additional lounge. This is pleasantly furnished, with comfortable seating, there is a small TV and a computer in this area for residents to use. One resident has the bedroom on the ground floor, the other three bedrooms are located on the first floor. There is a bathroom and staff bed room on this floor as well as a small office. The home is well furnished and maintained to a high standard. All the bedrooms have a lockable metal cupboard for residents. Two residents bedrooms seen were personalised and attractively presented. Bathroom facilities are located on ground and first floors, all are hygienic and cleaning is to a high standard. The home has a TV with sky programmes in the communal sitting area; there is also a Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: water cooler and a notice board with information for residents. There is a pay phone in the hall. The home is well maintained, it is kept clean and hygienic. Fridge and freezer temperatures are monitored daily. A recent environmental health inspector awarded this service five stars following an inspection visit. The ground floor has a kitchen and a utility room with a shower room and WC leading from this. The utility room is equipped with a washing machine and dryer. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is thriving as a result of the investment in the staff team. The home is supported by a skilled and competent staff team that receive good induction training. Competencies are retained as staff keep their skills and expertise constantly updated via the training programme. Residents are protected and safeguarded by robust recruitment procedures. Evidence: We found that appropriate numbers of staff were present on duty, staffing rotas for past months reflect that staffing levels are maintained at suitable levels. At night there is one sleepover night staff member, a local on call manager is always available. Comments from residents suggest that they feel confident and secure in the knowledge that skilled staff are present and available to support them. We examined recruitment procedures for three of the staff engaged. All the files contain correct and appropriate documentation. Application forms are fully completed and are supported with relevant references. Records show that CRB and POVA checks are in place for each staff member before they start work. In reference requests the supplying refereee is not always forwarding a headed compliment slip or a stamp. It is recommended that an addition is made when seeking professional reference requests, and that a stamp or headed notepaper Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: is requested from the referee. A significant investment is made in staff training. We observed that staff morale is good, also dedication by staff present to promoting good practice. Staff at the home tell us they receive a full induction programme in the first months, POVA training is included in the induction process. Records too of training and development confirm the extent of the training and development. After this training and development needs are assessed. all employees receive the necessary training that equip them for their role. We found that staff are provided with a comprehensive training pacakage that compliments mandatory training. Staff also participate in training provided by the community mental health team. From discussions with two coordinators from the mental health team it is evident that training and development is prioritised at the home. One care coordinator said while some services are unable to plan for the absence of colleagues attending training this home goes the extra mile to ensure that members of staff are made available to attend training. We heard how the training provision is reflected in the expertise and skills of the staff team. The service is achieving excellent results and delivering on outcomes and expectations. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Those using this service benefit from living in a well run home that focuses on achieving the best outcomes for individuals. Equality and diversity, human rights and person centred thinking are given priority at this home. People feel confident in the management of the service as it provides an imaginative and effective leader who consistently delivers high quality services. Evidence: We found evidence from many areas that confirm that this home is well run. Residents value the professional approach and attitude of the registered manager, during observations we saw how effective the relationship is between the manager and residents. We heard of the dedication of the manager to providing a stable and happy environment for people to live and work in. The home has good health and safety practises in place. Records were seen of daily recordings of fridge/freezer temperatures. Fire alarms are tested weekly, and three monthly fire drill are undertaken. All food hygiene policy and procedures are adhered to. A recent environmental health inspection awarded the Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: home a five star rating. The organisation has an effective system to monitor and evaluate the service. It completes an annual quality assurance survey. It incorporates the views of residents, relatives and MDT stakeholders to ensure that the high standard of service is maintained. According to professionals from the community mental health team this service is rated very highly and people using the service have a history of achieving outcomes successfully and moving to independent living units. The manager is a strong leader and offer clear guidance to to residents and staff. She is a qualified experience nurse that is driven by her empathy for those that are disadvantaged by mental health related issues. The manager communicates a clear sense of direction, is able to evidence a sound understanding and application of best practice, particularly in relation to continuous improvement, customer satisfaction, and quality assurance. Equality and diversity, and person centered operations are given priority by the manager who is able to demonstrate a high level of understanding and demonstrate best practice in these areas. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 20 It is recommended that the receiving pharmacist stamps the returns book when unwanted medication is returned to the pharmacist. It is recommended that an addition is made to record when seeking professional reference requests, and that a stamp or headed notepaper is requested from the referee. 2 34 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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